Need help regarding my mother!!

[klp7]

Let me give a brief history: My mom is 52 years and has had chronic pain most of her life due to back problems.  Most notabley is a sack of fluid on her spine that has calcified(pseudomenigiseal??) Also has chronic fatigue syndrome and was recently given a pacemaker.

The reason I write, though, is b/c a little under a month ago she was placed in the hospital for pneumonia.  She was experiencing high fever and hallucinations but no apparent lung ailments (from what I was told by family).  She was in the hospital for three days and released.  For the first week she was extremely fatigued but ok considering.  However, for the past two weeks she has been experiencing extreme mental confusion.  From the time she wakes up until she goes to bed she is 'out of it'(That is the best way I know how to describe it).  At first I thought she was taking too many pills (is prescribed oxycodon, loracet, valium, etc. by pain management dr. for chronic back pain) but my dad says that she is barely taking her daily doses b/c she is so out of it.  She looks drugged, has a hard time w/ comprehension, etc.  There are times when my dad has to feed and clothe her!  They have been to their pain doctor a couple times since her contracting pneumonia and he says that the mental confusion is lingering affects of the pneumonia, but this just does not sit well w/ me.  This is the worst I have ever seen my mom and I have a hard time beleiving that it is b/c of the pneumonia.  Also, she does not have a fever or any serious breathing issues (phlegm, coughing, etc.).

Could this really be b/c of the pneumonia?
Right now my Dad and I are at a loss!!

Thanks,

[Demiguise]

I would find it also odd w/ pneumonia yet no lung problem.
Everyone has some good ideas but I'd think pneumonia would've
shown signs over a month before admitting. The tolerance of her
Rx are considered along w/ Dads input of what he thinks. I
would start w/ her records. Call hospital in files room & ask
for a release form to have Mom sign you access to all copies
of her treatment, etc. These are usually free for 1st set & also copies on any xray reports done, meds given. These copies
may not make alot of sense but will give you more understanding
& perhaps you could ask her reg. doc or google words. Start a
"home health file" & that's a good statement showing concern.
Also get copies from her reg. MD ofc. to see what blood-wk was
done. The law allows this info as long as you have a release.
The files will tell you what other meds she was treated with.
You could take your Dad along & he can get records quicker
since he is guardian/husband. Good luck.

[B_Johnson]

Ozark has made a good point.  Considering her history of back pain, a serious kidney or urinary infection, which also would cause back pain, may be masked by this.

Also considering the amount of pain medication you mother was on, these could be witdrawl effects from not taking them.  Valium and other benzodiazapines require a period of several weeks of tapering before discontiuation.  The opiates such as the oxycontin may result in a withdrawl syndrome which would lead to confusion, grogginess, and sometimes even hallucinations.

While i dont understand how your physician made the diagnosis of pneumonia without there being any lung abnormalities, fever in and of itself can be the cause of some mental confusion also, but should not be present after the fever (which would also indicate that any type of infection has also cleared).

Another cause of confusion could be due to electrolyte abnormalities most of which should have been corrected during her hospitalization.

The spinal lesion you described would be more likely to cause peripheral neurological deficits such as weakness, pain and sensory loss.  Central deficits such as mood and confusion are very unlikely.

If these symptoms are still continuing, i would consider another visit to a different hospital and ER.

-Dr. J

[ozark]

have they tested her for a urine infection?? this can cause mental changes. good luck

[Kevin Pho, MD]

There can be many causes for the change in mental status.  Certainly the various doses of pain medications can lead to the symptoms - however, if the symptoms are continuing you may want to consider a neurology evaluation for further testing.

Infection stemming from the pneumonia can cause lingering mental status changes.  I would also consider a CT scan and/or an MRI of the brain to look for further neurological pathology.

A spinal tap can be considered to evaluate for various forms of encephalitis or meningitis.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b